Gallbladder Abnormal Changes Caused by Liver Parenchymal Diseases Versus Inflammatory Cholecystitis: Differential Diagnosis by MultiDetector Row Spiral CT_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WU Yinghua ¹ , SONG Bin ¹ , LUO Xiaohua ² , CHENG Yan ¹ , XU Juan. ³

Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

Keywords：

Hepatic disease Cholecystitis X-ray/Computed tomography Differential diagnosis

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【Abstract】ObjectiveBy using multidetector row spiral CT (MDCT) to investigate the CT imaging findings of gallbladder abnormalities caused by hepatic parenchymal diseases and those of inflammatory cholecystitis.
MethodsCT and clinical data of 80 patients with gallbladder abnormalities were retrospectively reviewed. Fifty patients were in hepatic disease group, including 20 chronic hepatitis, 25 liver cirrhosis, and 5 cirrhosis with hepatocellular carcinoma. Thirty patients were in inflammatory group, including 19 chronic cholecystitis, 6 acute cholecystitis, 3 cholecystitis with acute pancreatitis, 1 gangrenous cholecystitis, and 1 xanthogranulomatous cholecystitis. All patients underwent MDCT plain scan and contrastenhanced dualphase scanning of upper abdomen.
ResultsIn hepatic disease group, 48 cases had evenly thickened gallbladder wall (96%) with mean thickness of (3.67±0.49) mm; 38 cases had clear gallbladder outlines (76%); 38 cases had gallbladder wall enhancement of various degree (76%); 14 cases had gallbladder bed edema and localized nondependant pericholecystic fluid collection (28%). In inflammatory cholecystitis group, 28 cases had obscuring gallbladder outlines (93%) ; 26 cases had gallbladder wall evenly thickened (87%), 4 cases showed unevenly thicked wall (13%), the mean thickness being (4.54±1.14) mm; 30 cases had inhomogenous enhancement of the gallbladder wall (100%); 9 cases had highattenuation bile (30%); 4 cases had dependant pericholecystic fluid collection (13%); 5 cases had transient enhancement of adjacent hepatic bed in arterial phase (17%); microabscess and gas in the gallbladder wall was observed in 1 case respectively.
ConclusionMDCT can offer imaging findings useful for differentiating abnormal gallbladder changes caused by hepatic parenchymal diseases from those due to inflammatory cholecystitis.

Citation： WU Yinghua,SONG Bin,LUO Xiaohua,CHENG Yan,XU Juan.. Gallbladder Abnormal Changes Caused by Liver Parenchymal Diseases Versus Inflammatory Cholecystitis: Differential Diagnosis by MultiDetector Row Spiral CT. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2005, 12(1): 82-86. doi: Copy

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1. 陶辉, 张宗宝. 厚壁型胆囊癌和慢性胆囊炎的CT鉴别诊断 [Ｊ]. 现代医用影像学， 1998; 7(5)∶218.
2. Yoshimitsu K, Hondo H, Shinozaki K, et al. Imaging disease of the gallbladder and the common bile duct on CT [Ｊ]. Clin Imagi， 1999; 15(3)∶930.
3. Mirvis SE, Vainright JR, Nelson AW, et al. The diagnosis of acute acalculous cholecystitis: a comparison of sonography, scintigraphy, and CT [Ｊ]. AJR Am J Roentgenol, 1986; 147(6)∶1171.
4. 罗小华，宋彬，陈卫霞，等. 慢性病毒性肝炎的CT表现 [Ｊ]. 中国普外基础与临床杂志， 2004; 11(5)∶458.
5. Fiske CE, Laing FC, Brown TW. Ultrasonographic evidence of gallbladder wall thickening: In association with hypoalbuminemia [Ｊ]. Radiology 1980; 35(2)∶713.
6. 杨光华主编. 病理 [M]. 第5版. 北京: 人民卫生出版社, 2001∶218～219.
7. Fidler J, Paulson EK, Layfield L. CT evaluation of acute cholecystitis: finding and usefulness in diagnosis [Ｊ]. AJR Am J Rotengenol， 1996; 166(5)∶1085.
8. 郭金玉. 病毒性肝炎病人合并胆道系统损害的超声诊断分析 [Ｊ]. 中西医结合肝病杂志， 2001; 11(2)∶98.
9. 段建军，欧强，沙新平. 肝炎和肝硬化病人胆囊超声改变的观察与分析 [Ｊ]. 中国现代医学杂志， 2003; 7(14)∶67.
10. Bennett GL,Rusinek H, Lisi V, et al. CT finding in acute gangrenous cholecystitis [Ｊ]. AJR Am J Rotengenol， 2002; 178(2)∶275.
11. 王克菲，武前文，许礼发，等. 失代偿性肝硬变患者胆囊壁增厚与腹水关系 [Ｊ]. 世界华人消化杂志， 2000； 8（5）∶598.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Gallbladder Abnormal Changes Caused by Liver Parenchymal Diseases Versus Inflammatory Cholecystitis: Differential Diagnosis by MultiDetector Row Spiral CT

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